2.50
Hdl Handle:
http://hdl.handle.net/10755/157145
Category:
Abstract
Type:
Presentation
Title:
Effective & Efficient Glucose Management in the Intensive Care Unit (ICU).
Author(s):
Myers, Jennifer; Chamnankit, Poome; Steuer, Jacquie
Author Details:
Jennifer Myers, Evanston Northwestern Hospital, Evanston, Illinois, USA, email: jenlindermuth@yahoo.com; Poome Chamnankit; Jacquie Steuer
Abstract:
PURPOSE: We hypothesized that comparable glycemic control could be achieved with a protocol that measured serum glucose every two hours instead of hourly. BACKGROUND: Aggressive management of hyperglycemia in the ICU has been shown to decrease mortality in selected patients. In 2004, we adopted the Yale Protocol (Diabetes Care 2004; 27:461). While a retrospective analysis of 24,108 serum glucose values in 1,497 patients at our institution demonstrated effective control of hyperglycemia, the protocol was labor intensive for nurses as it required hourly monitoring utilizing a complex calculation of insulin dosing. METHODS: We conducted a prospective pilot study involving 14 patients and 316 glucose measurements. Primary endpoints included (1) time to target glucose of 140mg/dL, (2) number of glucose measures relapsing above 140mg/dL once target was achieved, and (3) the incidence of hypoglycemia (<60mg/dL). These endpoints were compared with the fore mentioned historical control group. A secondary endpoint included nursing compliance with glucose measurements every two hours. RESULTS: A target glucose =140mg/dL was achieved in a mean of 9.5 +/- 5.5 (95% CI) hrs using the new protocol compared with 6.0 hrs in the historical control group. Once target glucose was achieved 43% of subjects in the pilot study had = 3 subsequent values that exceeded 140mg/dL compared with 50% of historical controls. Hypoglycemia occurred in 1.27% compared with 1.0%. Compliance with the Q 2 hour measurements was 94.2%. CONCLUSIONS: Comparable glucose control can be achieved in the ICU using a protocol with a 2-hour compared with a 1-hour measurement. This protocol was less labor intensive & nursing compliance was high.
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Citation:
2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.
Conference Date:
2009
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
New Orleans, Louisiana, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleEffective & Efficient Glucose Management in the Intensive Care Unit (ICU).en_GB
dc.contributor.authorMyers, Jenniferen_GB
dc.contributor.authorChamnankit, Poomeen_GB
dc.contributor.authorSteuer, Jacquieen_GB
dc.author.detailsJennifer Myers, Evanston Northwestern Hospital, Evanston, Illinois, USA, email: jenlindermuth@yahoo.com; Poome Chamnankit; Jacquie Steueren_GB
dc.identifier.urihttp://hdl.handle.net/10755/157145-
dc.description.abstractPURPOSE: We hypothesized that comparable glycemic control could be achieved with a protocol that measured serum glucose every two hours instead of hourly. BACKGROUND: Aggressive management of hyperglycemia in the ICU has been shown to decrease mortality in selected patients. In 2004, we adopted the Yale Protocol (Diabetes Care 2004; 27:461). While a retrospective analysis of 24,108 serum glucose values in 1,497 patients at our institution demonstrated effective control of hyperglycemia, the protocol was labor intensive for nurses as it required hourly monitoring utilizing a complex calculation of insulin dosing. METHODS: We conducted a prospective pilot study involving 14 patients and 316 glucose measurements. Primary endpoints included (1) time to target glucose of 140mg/dL, (2) number of glucose measures relapsing above 140mg/dL once target was achieved, and (3) the incidence of hypoglycemia (<60mg/dL). These endpoints were compared with the fore mentioned historical control group. A secondary endpoint included nursing compliance with glucose measurements every two hours. RESULTS: A target glucose =140mg/dL was achieved in a mean of 9.5 +/- 5.5 (95% CI) hrs using the new protocol compared with 6.0 hrs in the historical control group. Once target glucose was achieved 43% of subjects in the pilot study had = 3 subsequent values that exceeded 140mg/dL compared with 50% of historical controls. Hypoglycemia occurred in 1.27% compared with 1.0%. Compliance with the Q 2 hour measurements was 94.2%. CONCLUSIONS: Comparable glucose control can be achieved in the ICU using a protocol with a 2-hour compared with a 1-hour measurement. This protocol was less labor intensive &amp; nursing compliance was high.en_GB
dc.date.available2011-10-26T19:27:40Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:27:40Z-
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.conference.date2009en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationNew Orleans, Louisiana, USAen_GB
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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